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HIV/AIDS and Disability

Around a quarter of people with HIV are unaware of their infection and at risk of passing on the virus to others through unprotected sex, according to public health officials. The growing relationship between HIV/AIDS and disability is an emerging issue and cause for concern as persons with disabilities are at higher risk of exposure to HIV.

Additionally, there is a growing understanding that persons living with HIV or AIDS are also at risk of becoming disabled on a permanent or episodic basis as a result of their condition.

Like any other person, persons with disabilities require information on HIV/AIDS and access to programmes, services, and resources. In most countries, the situation of persons with disabilities is further compounded by societal barriers that hinder their full and effective participation in society, including access to education. Despite the growing relationship between HIV/AIDS and disability, persons with disabilities have not received sufficient attention within national responses to HIV and AIDS. Furthermore, existing HIV prevention, treatment, care and support programmes generally fail to meet their specific needs. Persons with disabilities are often excluded from HIV education, prevention and support services because of assumptions that they are not sexually active or do not engage in other risk behaviours such as drug use.

Sexual and reproductive health service providers may lack knowledge about disability issues, or have misinformed or stigmatizing attitudes towards person with disabilities. Services offered at clinics, hospitals and in other locations may be physically inaccessible, lack sign language facilities or fail to provide information in alternative formats such as Braille, audio or plain language. In places where there is limited access to medication, persons with disabilities may be considered a low priority for treatment.

Women and girls with disabilities are especially vulnerable to sexual assault or abuse. Persons with intellectual impairments and those in specialized institutions are also at particularly high risk. Around the world, children with disabilities are a large proportion of the children and persons with disabilities not enrolled in school, which results in their exclusion from vital sexual and reproductive health education that is often provided in school settings. Low literacy levels and a lack of HIV prevention information in accessible formats, such as Braille make it all the more difficult for persons with disabilities to acquire the knowledge they need to protect themselves from being infected.

A report by Public Health England, in advance of National HIV Testing Week, shows there are now nearly 110,000 people living with HIV in the UK – demonstrating the continuing transmission of a disease once viewed as a virtual death sentence into a manageable long-term condition.

But it warned that around a quarter of these, 26,100, are unaware of their infection and at risk of passing on the virus.

“We can’t overstate the importance of testing for HIV to ensure an early diagnosis”

Valerie Delpech

However, it noted “encouragingly” that the proportion of people diagnosed with a late stage of HIV infection fell from 57% in 2004 to 42% in 2013.

The report shows around 6% of gay and bisexual men are now living with HIV, rising to 13% in London – with 3,250 newly diagnosed in 2013, an all-time annual high.

It is estimated that over 7,000 gay men have an HIV infection that remains undiagnosed and that an estimated 2,800 men acquired HIV in 2013.

The figures underline the need to further increase both the numbers and frequency of HIV tests, which is critical to tackling the ongoing high levels of HIV transmission, said the report.

While the large majority of black Africans do not have the HIV infection, the report also highlighted the fact that one-third of the 40,000 black African heterosexual men and women living with HIV in the UK do not know they have HIV.

“There is a dangerous complacency in our society about the challenge of HIV”

Deborah Gold

Dr Valerie Delpech, head of PHE ‘s national HIV surveillance, said: “We can’t overstate the importance of testing for HIV to ensure an early diagnosis.

“In 2013, people diagnosed with HIV late were 10 times more likely to die in the first year of diagnosis, compared to those diagnosed promptly. People who remain unaware of their infection are also at risk of transmitting HIV to others,” she said.

“Knowing one’s HIV status is the key to both effective treatment, and to preventing onward transmission. This is why we are promoting the National HIV Testing Week,” she added

Deborah Gold, chief executive of the National AIDS Trust, said: “Whilst we have passed the 100,000 mark for the number of people living with HIV in the UK, there is a dangerous complacency in our society about the challenge of HIV.

“The high rates of undiagnosed HIV are unacceptable but we are failing across the NHS and in the community consistently to offer HIV tests to those who need them, especially heterosexual men and women,” she said.

Progress is possible but there is still an immense amount to do to get everyone with HIV diagnosed in good time and meet the UN 90-90-90 target of just 10% undiagnosed,” she added.